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ICD-10 Guide
ICD-10 CodesI63.213

I63.213

Billable

Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I63.213 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries refers to a type of stroke that occurs when blood flow to a part of the brain is obstructed due to narrowing or blockage of the vertebral arteries. These arteries are crucial as they supply blood to the posterior circulation of the brain, which includes the cerebellum and brainstem. Clinical presentation may include sudden onset of neurological deficits such as weakness, numbness, difficulty speaking, or loss of coordination. The disease progression can vary; some patients may experience transient ischemic attacks (TIAs) before a full-blown stroke, while others may present with acute symptoms. Diagnostic considerations include imaging studies like MRI or CT scans to identify the infarction and assess the extent of vascular occlusion or stenosis. Understanding the underlying cause is essential for effective management and prevention of future strokes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation, rehabilitation, and management of risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary.
  • Coding specificity: Requires precise documentation of the occlusion or stenosis.

Audit Risk Factors

  • Common coding errors: Misidentifying the type of occlusion or stenosis.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history or imaging results.
  • Billing challenges: Potential denials if the documentation does not clearly support the diagnosis.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. The prevalence of strokes due to vertebral artery occlusions highlights the need for effective prevention strategies and management of risk factors. Quality measures related to stroke care, such as timely imaging and intervention, are crucial for improving patient outcomes. Understanding the epidemiology of this condition can help healthcare providers allocate resources effectively and enhance care delivery.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. The prevalence of strokes due to vertebral artery occlusions highlights the need for effective prevention strategies and management of risk factors. Quality measures related to stroke care, such as timely imaging and intervention, are crucial for improving patient outcomes. Understanding the epidemiology of this condition can help healthcare providers allocate resources effectively and enhance care delivery.

Reimbursement & Billing Impact

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. The prevalence of strokes due to vertebral artery occlusions highlights the need for effective prevention strategies and management of risk factors. Quality measures related to stroke care, such as timely imaging and intervention, are crucial for improving patient outcomes. Understanding the epidemiology of this condition can help healthcare providers allocate resources effectively and enhance care delivery.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I63.213?

I63.213 covers cerebral infarction resulting from unspecified occlusion or stenosis of bilateral vertebral arteries. This includes strokes that may arise from embolism, thrombosis, or other vascular issues affecting these arteries.

When should I63.213 be used instead of related codes?

I63.213 should be used when the occlusion or stenosis of the vertebral arteries is not specified. If the occlusion is known to be unilateral or if the specific artery involved is documented, then related codes such as I63.211 or I63.212 should be used.

What documentation supports I63.213?

Documentation should include a detailed clinical assessment, imaging studies (CT or MRI) showing the infarction, and notes on the patient's history of vascular disease or risk factors contributing to the stroke.